17717 (2) 7764 OROGRANDE PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Dafe----------I D-17� -------------.....--------.. 197J... Permit No.------------- --7--7---'----...
The undersigned herby makes,*,��lication to the plumbing Inspector of the City of San Jose
for a permit to install plu�pb�'�ppg�fixtdFef afidiYor�prpes lis�6d u e reverse side.
Exemption from raquir6m9nt for STaI�oHCalifomi {�Qnfrecfor's License is hereby claimed
by undersigned: v as owner ❑ statement filed ❑ /7/4-37
Undersigned attests that is State of California Contractor'' Licenseof the work #
aufhor
is in full force and effect and properlyize" tRls application / (/
San Jose City Business License # 4�T
1 certify that in the performance ich thisa permit is issued I shill not employ
any person in any manner as to violafo the workmen's compensation laws of California.
OWNERn ,n
ADDRESS -7-7 �o �-d� NLi Lot No. 43
USE OF JU G
280-30(9'73) Signed ......{t" LO.LCQ.�Q.e.ye-'---- .
7764 OROGRANDE PLACE , CENTRAL SERVICE
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